Local Client Form

Thanks!

Congratulations on taking the very smart step of getting your business found online!

We’d like to get started as quickly as possible getting your business listings optimized, but first we’ll need some information from you about your business. For your convenience, we’ve created the following form which puts everything we’ll need from you to do our jobs in one place.

Client Data Form

Client Data Form

Please fill out all of the fields as completely as possible. The more complete your entries, the better we'll be able to do our work and get your business ranked highly for local searches. If you have any questions, please contact us using the information on our contact page."

Basic Business Info

Business Name*

Parent Company/Corporate Name

Primary Contact's Full Name*

Primary Contact's Email*

Primary Contact's Date of Birth*

This is necessary for the creation of Google Account(s) for your campaign. Don't worry – we keep it safe!

Main Company Email Address*

Main Company Local Phone Number*

Alternate Phone Number

Toll-Free Phone Number

Fax Number

Mobile Phone Number

Should your mobile phone number be visible on public listings?

Yes

No

Street Address*

Street Address Line 2

City*

State / Province*

Postal / Zip Code*

Country

List any other business names that have been used in the past

List any other phone numbers that have been used by your business in the past

List any other addresses that your business belonged to in the past

Business Tag Line / Motto / Slogan

Business Description*

The Story of Your Business

Services Offered

Products Carried

Brands Carried

Specialties

List of Cities / Geographical Area(s) Serviced*

Number of Locations*

Number of Employees*

Language(s) Spoken At Your Business*

Year Business Founded*

Website & Social Media Info

Company Website*

If you do not yet have a website, specify.

Website Login Username

We will be making updates to your website's on-page ranking factors (if you aren't receiving a freshly built website from us)

Website Login Password

Link to Coupon / Incentive Offer

Description of Special Offer, Discount, or Coupon

Links to Photos

Links to Videos

Social Networking & Review Sites

Select all that apply.

Google My Business

Bing Local

Yahoo! Local

Facebook (Business/Fan Page)

Google+

Twitter

LinkedIn

YouTube

Yelp

FourSquare

Super Pages

City Search

Insider Pages

Kudzu

Angie's List

Judy's Book

Merchant Circle

Yellow Pages (YP.com)

Are you aware of the existence of multiple Google My Business (Maps) listings for your business?

If Yes, explain below.

Yes

No

Describe specifics about these multiple listings

Circumstances, who created them, additional login info, etc.

Links to Positive Reviews

List of terms that you would use to search for your products/services on search engines*

"Power Pages" for Local SEO

As a part of your SEO campaign, we will be generating Power Pages for the purpose of ranking your business' services locally.

Power Pages are city-and-keyword specific pages that we pump both on-page and off-page optimization toward.

For example, here are some examples of Power Page topics for a Limousine company:

{City Name} {Keyword Phrase}

Santa Rosa Limousine Rentals

Rohnert Park Wine Tours

Sonoma Corporate Transportation

By default we generate pages for 3 keywords and 5 cities (for 15 pages total). If you need more than this, please inquire for a price quote.

Provide up to 5 cities that you would like us to target in SEO campaign*

We may create content for you as a part of your services. Please list up to 5 cities that are most significant to your business. Please place your primary target city as the first one on this list. Press the (+) button to add a new row.

Provide up to 3 services/keywords that you would like to rank*

For example, if you are a Limo company, you might include: "Limo Rentals, Wine Tours, Party Bus Rentals". Important: We will do our research and make the final decision what content you will benefit most from. Your response will help us perform this research.

Use this field to offer additional information regarding business hours. Are there holidays you are closed? Do you have an unusual hour schedule you'd like to explain more about?

Upload Company Logo & Photos

Pictures are critical to successful, highly ranked listings. Please upload to us a .ZIP archive file containing your company logo artwork as well at least 5 and preferably 10 photos related to your company (building exterior/interior, job photos, employees, products you make, etc.) Photos should be in JPG or PNG format where possible, and please be sure that you own the copyright or a license permitting you to use all photos provided. Our company will not be responsible for copyright infringement issues related to materials provided by you for use in your listings.

Drop files here or

Authorization and Acknowledgement of Terms of Service

I hereby state that I am an authorized representative of the above business, and authorize your company to use of all our provided and existing business logos, trademarks, Web site images, etc., for use in creating directory listings, informational pages, and any other uses as deemed necessary by your company for the purposes of marketing and promoting our business online. I understand that the increased visibility from said listings may in some cases increase the number of telephone solicitations we receive in the future by sales representatives of the listings organizations. I further understand that a local call tracking number of your choosing may be employed with our online listings to allow for the long-term trackings of inbound calls to our business from online listings, and authorize your company to secure said number for us and utilize it as a forwarding number to our main contact phone number listed above, or other number we specify. We understand that the companies with whom our listings are created, and the call tracking number company are separate business entities from your company, and that we and not you are solely responsible for the long-term costs and account management related to the call tracking number, and furthermore agree to hold your company harmless with regards any loss or damages to our business related from issues that may arise with either our online business listings or the call tracking number. We understand the costs of the call tracking number are only covered so long as we are under a SEO-related monthly services contract with your company, and outside such contract that the continuance of said number is our sole financial and managerial responsibility.

Authorization and Release to Perform Work*

I understand and acknowledge the above and authorize your company's agents to represent our company in performing the work described herein.

Client Testimonials

Sean and Jason are an awesome team that designed a perfect website with my vision and needs taken care of 100%. So glad I found and hired SMN for my website and campaign. I have nothing but confidence these guys will get the job done and take my busi... (Read More)

Written by Bryce "Modern Maestro" Williams

Social Media Ninjas is rated
5 stars over
22 reviews.

This site collects and processes information that you provide. We explain how we use and process your information in our privacy page. We do not permit form submissions outside of the United States, as that is outside our area of service.